不同骨代谢状态下T2DM患者血清25(OH) D及Omentin-1水平的变化及其意义
Changes and significance of serum 25-OH vitamin D and omentin-1 levels in different bone metabolism status of patients with type 2 diabetes mellitus
  
DOI:10.3969/j.issn.1006.7108.2017.11.002
中文关键词:  2型糖尿病  骨质疏松  25-羟维生素D  网膜素-1  骨代谢
英文关键词:Type 2 diabetes mellitus  Osteoporosis  Omentin-1  25(OH)D  Bone metabolism
基金项目:国家自然科学基金(81460168);贵州省科学技术基金项目(黔科合J字LKZ[2013]19号);遵义医学院博士启动基金([2012] F-574)
作者单位
王莲地1 王贺1 阳琰1* 张国豪2 刘贝贝1 李琪1 1.遵义医学院附属医院内分泌科,贵州 遵义563099 2.贵州茅台酒厂集团公司职工医院,贵州 遵义564501 
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中文摘要:
      目的 检测不同骨代谢状态下2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清中25-羟维生素D、Omentin-1水平的变化,初步探讨它们在T2DM合并骨质疏松(osteoporosis,OP)发生发展过程中的作用。方法 收集2016年2月至2017年1 月在遵义医学院附属医院内分泌科住院的T2DM患者140例,据骨密度分为3组:T2DM骨量正常组(A组45例)、T2DM骨量减少组(B组45例)、T2DM骨质疏松组(C组50例),收集同期医院体检中心年龄、性别相匹配的健康体检者为正常对照组 (NC组120例)。酶联免疫吸附(ELISA)法测定所有受试者血清25(OH)D、Omentin-1水平;多元逐步回归分析骨密度的影响因素。结果 ①T2DM组空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白(hemoglobin A1c,HbA1c)、稳态模型评估的胰岛素抵抗指数(homeostasis model assessment insulin resistance, HOMA-IR)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)水平较NC组明显升高,而高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)明显降低(P < 0. 05);②C组25(OH)D、Omentin-1水平显著低于NC组、A组及B组;B组低于NC组及A组;A组低于NC组,即C组
英文摘要:
      Objective To detect the levels of serum 25( OH) D and omentin-1 in different bone metabolic status of patients with type 2 diabetes mellitus (T2DM) and to explore their roles in the occurrence and development of osteoporosis. Methods A total of 140 T2DM cases were selected in the Department of Endocrinology,the Affiliated Hospital of Zunyi Medical College,from Feb 2016 to Jan 2017. They were divided into 3 groups according to bone mineral density (BMD): normal bone mass group (A group,45 cases),bone mass loss group (B Group,45 cases),osteoporosis group (C group,50 cases). 120 healthy and age and gender- matched cases were collected from the physical examination center of our hospital and served as normal control group ( NC group) . Serum levels of 25( OH) D and omentin-1 were measured using enzyme-linked immunosorbent assay. The influence factors were analyzed with multiple regression analysis. Results (1) The levels of FBG,HbA1c,HOMA-IR,and LDL-C in T2DM group were significantly higher than those in NC group (P <0. 05),but HDL-C level decreased significantly. (2) The levels of 25(OH) D and omentin-1 in C group (17. 18 ±2. 51 ng/mL and 47. 56 ±6. 52 ng/mL) were significantly lower than those in NC (27. 41±4. 44 ng/mL and 65. 24 ±8. 39 ng/mL),A (23. 58 ±3. 61 ng/mL and 63. 58 ±6. 77 ng/mL),and B (20. 46 ± 3. 46 ng/mL and 59. 28 ±5. 16 ng/mL) group,i. e.,C < B < A < NC (P < 0. 05 ). (3 ) Multiple regression analysis showed that BMD was positively correlated with omentin-1 and 25 (OH) D,but negatively correlated with disease duration and HbA1c in patients with T2DM and OP (P <0.05). Conclusion The levels of 25 (OH) D and omentin-1 in T2DM patients were lower than those in healthy people,and they gradually decrease from normal bone mass,bone mass loss,to osteoporosis group. The finding suggests that low levels of omentin-1 and 25(OH) D may be involved in the occurrence of osteoporosis in T2DM patients.
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